Colorectal carcinogenesis is the result of accumulation of genetic and epigenetic alters.Gene mutations and changes in DNA methylation patterns,resulted from genomic instability,are the main molecular events in colorectal cancer.Identification of key mutations and methylation phenotypes in genes leading to colorectal cancer progression,and molecular pathology classification and diagnosis are likely to be the prerequisites for individualized and targeted treatment.

Objective:To explore the necessity of monitoring polysomnography (PSG ) in snoring children.Method:The PSG were monitored in 162 children with snoring or apnea.Acording to results of PSG,162 cases were separated into two groups:group obstructive sleep apnea hypopnea syndrome(OSAHS) and group primary snoring(PS),monitoring data including:apnea hypopnea index(AHI),snoring index(SI),lowest oxygen saturation(LSaO_2) and time of SaO_2<0.9,all data were undertaked statistical analysis. Result:In all 162 snoring cases,150 cases(92.6%) belong to group OSAHS,12 cases(7.4%) belong to group PS;Differences of data of age,sex and body mass index(BMI) are not significant but that of AHI,SI,LSaO_2 and time of SaO_2<0.9 are significant(P<0.05).Conclusion:It's necessary to monitor PSG in snoring children for early diagnosis and correct treatment to avoid disadvantage of OSAHS.

Objective To determine the prevalence and influencing factors of urinary calculi,to explore the interIrelationships between urinary stone disease and various risk and protective factors,to determine the potential implications for intervention and prevention in Changsha,and to evaluate the relative importance of each risk factor,with the objective of providing scientific guidelines for urinary calculi prevention and diagnosis. Methods A case-control study was designed,and 66,772 people were surveyed.Ultrasound examination,blood biochemistry,general physical examination,gender and age were asked in a questionnaire to determine a diagnosis of urolithiasis.By means of SPSS software a x2 tendency test and non-condition Logistic regression were conducted. Results A multivariate Logistic regression analyses was conducted.The final factors entered into the model were sex,age,profession,dietary habits,drinking habits,smoking and level of uric acid. Conclusions Hazard factors associated with urolithiasis are male gender,age,profession,dietary and drinking habits,smoking and level of uric acid.

Circulating tumor cells (CTCs) in breast cancer patients can be detected by Cell Search system. Results from recent studies suggested that CTCs level might serve as a prognostic marker and be used in the early assessment of therapeutic response in patients with metastatic breast cancer. However the role of CTCs in early stage breast cancer is not well established. Large prospective trials are needed to further understand its biological characteristics and to confirm its role as a predictive and prognostic marker.

ObjectiveTo seek the approach to the initial diagnosis of pulmonary embolism through analysis and conclusion of the clinical features of pulmonary embolism.MethodsThe high risk factors,clinical manifestation and results of common auxiliary examinations of 23 patients with pulmonary embolism were analyzed retrospectively.ResultsThere were 91.30％(21/23)patients with high risk factors.The common symptoms were dyspnea (91.30％,21/23) and chest tightness (69.57％,16/23 ),while the triad of pulmonary embolism merely accounted for 13.04％ (3/23).And other symptoms included palpitation,chest pain,hemoptysis and syncope,etc.Blood gas analysis indicated that there were hypoxemia and hypocarbia.The positive rate of D-dimer was 91.30％ (21/23).The abnormal rate of electrocardiogram was 91.30％( 21/23 ) and the abnormal rate of echocardiography was 86.96％(20/23).ConclusionAppropriate approach to the initial prognosis can help to establish the diagnosis of patients with suspected pulmonary embolism as early as possible,as well as differentiate other cardiopulmonary diseases.

Objective To describe clinical and functional features of patients with left main coronary artery (LM) stenosis. Methods Significant stenosis was defined as ≥ 50%.One hundred and eighty-eight patients with LM stenosis and 200 patients with clinically suspected coronary heart disease (CHD) without LM stenosis were enrolled. Results (1) The incidence rate of LM stenosis was 5.59%.(2) Patients with LM stenosis all had risk factors.Furthermore,featured older age,higher incidence of angina pectoris,and the same incidence of myocardial infarction history when compared with the patients without LM stenosis.(3) The left ventricular ejection fraction was lower in patients with LM stenosis than that in patients without LM stenosis,and it was lower too in patients with isolated LM stenosis than in patients with LM stenosis accompanied by triple vessel stenosis.The left ventricular end diastolic pressure showed no significant difference among various groups. Conclusion Patients with LM stenosis feature older age,severe angina pectoris.Furthermore, most of them are accompanied by other vessel lesions.Most LM stenosis are located at the ostium and the crotch of LM is presented as stenosis

Objective To carry out patients' participation in promoting health care workers(HCWs) to improve hand hygiene (HH) compliance in the outpatient transfusion room, obtain real data of HH, and further provide basis for performing the activity in the whole hospital.Methods HH compliance of nurses in outpatient transfusion room during four stages was observed by using the healthcare-associated infection control toolkit mobile phone APP.Intervention was not implemented at the first stage, HH promotion was implemented at the second stage, simulation of patients participated in promoting HCWs to improve HH compliance was performed at the third stage, and patients actually participated in promoting HCWs to improve HH compliance at the fourth stage.A questionnaire about patients' willingness to participate in the promotion of HCWs to improve HH compliance was developed and filled out by patients and nurses.Results HH compliance rates of nurses in transfusion room at four stages were 21.43%, 44.27%, 61.48%, and 82.88% respectively, differences was significant(χ2=110.35,P<0.01);HH correct rates at four stages were 44.44%, 74.14%, 81.33%, and 81.82% respectively, differences was significant(χ2=18.50,P<0.01).Conclusion Patients participating in promotion of HH can significantly improve HH compliance of HCWs, which is simple and effective, and worth to be popularized.

Radiotherapy has been proven to enhance tumor-specific immune response and provide targets for immune drugs. Immune checkpoint inhibitors represented by PD-1/PD-L1 combined with radiotherapy can enhance anti-tumor activity and exert abscopal effect. In this article, research progress on the basic study and clinical trials and challenges of radiotherapy combined with PD-1/PD-L1 inhibitors in the treatment of breast cancer were reviewed.

Kawasaki disease(KD) is a childhood acute self-limiting systemic vasculitis.It is an autoimmune disease.It has replaced rheumatic fever as the most common disease of children with acquired heart disease.Further study of the pathogenesis of KD,help to improve the individualized treatment and prognosis of the disease.The current study on KD,corfirmed its susceptibility to disease and clinical symptoms associated with multiple gene loci,there may be multiple signal paths involved.This paper reviews the recent advances in the genetic and immunological mechanisms of KD.

Objective To observe the effects of hyperbaric oxygen (HBO) on the expression of NF-?B and ICAM-1 after cerebral ischemia-reperfusion in rats. Methods The middle cerebral artery occlusion-reperfusion (MCAOR) model was established by using Zea-Longas method in rats. Seventy-two rats were recruited in this study and randomly divided into 3 groups: a cerebral ischemia-reperfusion group (CIR group),a CIR+HBO group(HBO group),and a sham-operation group(SO group). The infarct volume of each group was measured by TTC staining technique, and the expression of NF-?B and ICAM-1 was measured at 24 h, 48 h, 72 h and 120 h, respectively, after reperfusion by using immunohistochemistry staining. Results The infarct volume in HBO group was significantly smaller than that in CIR group (P